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Carotid Body Function in Type 2 Diabetes Mellitus (CBHypoxia)

Primary Purpose

Diabetes Mellitus, Type 2, Hypoxia

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Hyperinsulemic-Euglycemic Clamp & Hypoxic Ventilatory Response (HVR)
Sponsored by
Leiden University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Diabetes Mellitus, Type 2

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion criteria

In order to be eligible to participate in this study, a subject must meet all of the following criteria:

  • 18 years and older
  • Subjects must be willing to give written informed consent for the trial and able to adhere to dose and visit schedule.
  • Non-insulin-dependent diabetes mellitus (NIDDM) or healthy sex, age (± 3 yrs) and BMI (± 3 kg/m2) matched controls.
  • Have no clinical or electrocardiographic signs of ischemic heart disease as determined by the Investigator with normal cardiac intervals appropriate for their gender. The Screening 12 lead ECG conduction intervals must be within gender specific normal range (e.g., QTcF ≤ 430 msec, PR interval ≤ 220 msec). ECGs are to be judged by the investigator or sub investigator as per standardized procedures.
  • Vital sign measurements must be within the following ranges: (Individuals with values outside (or indicate lower or higher) of these ranges may be enrolled if clinically acceptable to the investigator and sponsor.

    • body temperature, between 35.5°C and 37.5°C
    • systolic blood pressure, 90 to 150 mmHg
    • diastolic blood pressure, 40 to 95 mmHg
    • pulse rate, 40 to 100 bpm
  • Subjects must be free of any clinically significant disease that would interfere with the study evaluations.
  • Subjects presenting out of range values of lab/ECG/vital signs compatible with normal variation of the normal healthy subject can be included in the study at the investigator's discretion and sponsor written approval.
  • Positive Allen's test
  • Fitzpatrick skin type I or II

A potential subject who meets any of the following criteria will be excluded from participation in this study:

  • Insulin dependent diabetes mellitus
  • Diagnosed Obstructive Sleep Apnea (OSAS) or high suspicion of OSAS determined by a STOP-BANG score > 5
  • Respiratory or cardiovascular disease
  • Smoking/vaping
  • Positive pregnancy test
  • conditions that result in elevated levels of methaemoglobinia
  • body mass index > 35 kg/m2
  • Use of illicit drugs
  • Use of prescription opioids or benzodiazepines
  • Failure of the drug of abuse tests at screening or check-in.
  • History of dyspnea, asthma, tuberculosis, chronic obstructive pulmonary disease, or any other ventilatory / lung disease.
  • Subjects with excessive facial hair preventing sealing of the occlusive face mask.
  • Subjects who, in the opinion of the investigator, will not be able to participate optimally in the study.
  • Subject who has a history of any infectious disease within 4 weeks prior to drug administration that in the opinion of the investigator, affects the subject's ability to participate in the trial.
  • Subjects who are part of the study staff personnel or family members of the study staff personnel.
  • Subjects who have demonstrated allergic reactions (e.g., food, drug, atopic reactions or asthmatic episodes) which, in the opinion of the investigator and sponsor, interfere with their ability to participate in the trial.
  • Personal or family history of arrhythmias or ECG conductance abnormalities.
  • Hypokalemia defined as <3.5 mmol/L

Sites / Locations

  • LUMC

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Diabetes Type 2

Healthy controls

Arm Description

Patients with DM Type 2 using Oral Diabetes Medications only.

Healthy controls without comorbidities.

Outcomes

Primary Outcome Measures

Chemosensitivity of carotid bodies during baseline and euglycemic clamp
L/min/PaO2

Secondary Outcome Measures

HRV during baseline and euglycemic clamp
HRV parameters

Full Information

First Posted
February 2, 2022
Last Updated
May 30, 2023
Sponsor
Leiden University Medical Center
Collaborators
Demcon
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1. Study Identification

Unique Protocol Identification Number
NCT05237076
Brief Title
Carotid Body Function in Type 2 Diabetes Mellitus
Acronym
CBHypoxia
Official Title
Carotid Body Dysfunction in Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
December 1, 2021 (Actual)
Primary Completion Date
August 5, 2022 (Actual)
Study Completion Date
February 15, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Leiden University Medical Center
Collaborators
Demcon

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial will assess chemosensitivity differences of the carotid bodies in individuals with T2DM, compared to healthy controls. During baseline and hyperinsulinemia.
Detailed Description
During the COVID-19 pandemic patients with comorbidities such as hypertension, diabetes mellitus, obesity and pregnancy were overrepresented in the population that was admitted to the hospital. Morbidity and mortality due to SARS-COV-2 infection was higher in these patients compared to patients without these comorbidities. The higher incidence, morbidity and mortality is suggestive of an underlying mechanism that puts these patients more at risk. A proposed mechanism is the sympathetic overactivity that is associated with these conditions. Recently, it has become clear that the carotid bodies play an important role in sympathetic overactivity in these conditions. Dysfunction of this organ is associated with decreased chemosensitivity, disruption of insulin sensitivity, but is also associated with changes in neurohumoral control in response to infection. Whether carotid body dysfunction can explain the severity of SARS-COV-2 infection remains to be seen. The aim of this study is to find whether patients with type 2 diabetes have altered chemosensitivity and are in fact sympathetically overactive compared to healthy controls and during a hyperinsulinemic-euglycemic clamp. Findings could help explain why type 2 diabetes patients are more heavily affected by SARS-COV-2 and could identify potential targets for treatment in these patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2, Hypoxia

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Multi arm pre-post study
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Diabetes Type 2
Arm Type
Experimental
Arm Description
Patients with DM Type 2 using Oral Diabetes Medications only.
Arm Title
Healthy controls
Arm Type
Active Comparator
Arm Description
Healthy controls without comorbidities.
Intervention Type
Diagnostic Test
Intervention Name(s)
Hyperinsulemic-Euglycemic Clamp & Hypoxic Ventilatory Response (HVR)
Intervention Description
Hyperinsulemic-Euglycemic Clamp as described by deFronzo et al.
Primary Outcome Measure Information:
Title
Chemosensitivity of carotid bodies during baseline and euglycemic clamp
Description
L/min/PaO2
Time Frame
5 minutes
Secondary Outcome Measure Information:
Title
HRV during baseline and euglycemic clamp
Description
HRV parameters
Time Frame
30 min

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion criteria In order to be eligible to participate in this study, a subject must meet all of the following criteria: 18 years and older Subjects must be willing to give written informed consent for the trial and able to adhere to dose and visit schedule. Non-insulin-dependent diabetes mellitus (NIDDM) or healthy sex, age (± 3 yrs) and BMI (± 3 kg/m2) matched controls. Have no clinical or electrocardiographic signs of ischemic heart disease as determined by the Investigator with normal cardiac intervals appropriate for their gender. The Screening 12 lead ECG conduction intervals must be within gender specific normal range (e.g., QTcF ≤ 430 msec, PR interval ≤ 220 msec). ECGs are to be judged by the investigator or sub investigator as per standardized procedures. Vital sign measurements must be within the following ranges: (Individuals with values outside (or indicate lower or higher) of these ranges may be enrolled if clinically acceptable to the investigator and sponsor. body temperature, between 35.5°C and 37.5°C systolic blood pressure, 90 to 150 mmHg diastolic blood pressure, 40 to 95 mmHg pulse rate, 40 to 100 bpm Subjects must be free of any clinically significant disease that would interfere with the study evaluations. Subjects presenting out of range values of lab/ECG/vital signs compatible with normal variation of the normal healthy subject can be included in the study at the investigator's discretion and sponsor written approval. Positive Allen's test Fitzpatrick skin type I or II A potential subject who meets any of the following criteria will be excluded from participation in this study: Insulin dependent diabetes mellitus Diagnosed Obstructive Sleep Apnea (OSAS) or high suspicion of OSAS determined by a STOP-BANG score > 5 Respiratory or cardiovascular disease Smoking/vaping Positive pregnancy test conditions that result in elevated levels of methaemoglobinia body mass index > 35 kg/m2 Use of illicit drugs Use of prescription opioids or benzodiazepines Failure of the drug of abuse tests at screening or check-in. History of dyspnea, asthma, tuberculosis, chronic obstructive pulmonary disease, or any other ventilatory / lung disease. Subjects with excessive facial hair preventing sealing of the occlusive face mask. Subjects who, in the opinion of the investigator, will not be able to participate optimally in the study. Subject who has a history of any infectious disease within 4 weeks prior to drug administration that in the opinion of the investigator, affects the subject's ability to participate in the trial. Subjects who are part of the study staff personnel or family members of the study staff personnel. Subjects who have demonstrated allergic reactions (e.g., food, drug, atopic reactions or asthmatic episodes) which, in the opinion of the investigator and sponsor, interfere with their ability to participate in the trial. Personal or family history of arrhythmias or ECG conductance abnormalities. Hypokalemia defined as <3.5 mmol/L
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Albert Dahan, MD, PhD
Organizational Affiliation
LUMC
Official's Role
Principal Investigator
Facility Information:
Facility Name
LUMC
City
Leiden
State/Province
Zuid-Holland
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
On request.

Learn more about this trial

Carotid Body Function in Type 2 Diabetes Mellitus

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